Provider Demographics
NPI:1144293002
Name:COLEY, CHRISTOPHER M (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:COLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS. GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:15 PARKMAN ST WAC 637
Practice Address - Street 2:INTERNAL MEDICINE ASSOCIATES TEAM 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-724-4600
Practice Address - Fax:617-724-7799
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA55636207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ04905OtherBCBS MA
MA055636OtherTUFTS HEALTH PLAN
MA3033759Medicaid
B74535Medicare UPIN
MA055636OtherTUFTS HEALTH PLAN